PHW Services — Certificates & Forms

Printable Templates

Professional certificates, assessment sheets and forms for FLT & Plant training. Click to preview, then print individually or all at once.

Unit Achievement Certificate (FLT)

Counterbalance / Teletruk forklift certification with 7 NOS-aligned units

Unit Achievement Certificate (Telehandler/Plant)

Telehandler, excavator and dumper certification with 8 NOS-aligned units

Practical Assessment — Counterbalance FLT

33-item scored assessment across pre-use, manoeuvring, load handling and post-op

Practical Assessment — Teletruk/Telehandler

Extended assessment with boom operation, reach work and banksman communication

Theory Test Answer Sheet

Answer grids for counterbalance (25 Qs) and teletruk (20 Qs) with scoring

Employer Authorisation Form

Formal authorisation to operate equipment with machine categories and fleet register

Pre-Use Inspection Checklist

Weekly landscape-format daily inspection grid with defect reporting

Course Attendance Record

Delegate sign-in sheet with theory/practical results and certificate tracking

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Unit Achievement Certificate

Forklift Truck Operations

Candidate Name:

Company / Employer:

Date of Assessment:

Certificate Number:

Units Achieved

FLT-01 Prepare the Forklift Truck for Driving or Manoeuvring

FLT-02 Operate, Move or Manoeuvre the Forklift Truck

FLT-03 Select, Transfer and Position Loads Using a Forklift Truck

FLT-04 Undertake Post-operational Checks on Forklift Trucks

FLT-05 Load Containers, Vehicles, Vessels or Platforms

FLT-06 Unload Containers, Vehicles, Vessels or Platforms

FLT-07 Health, Safety and Security at Work

Truck Type

Counterbalance

Teletruk

Both

This certification is aligned to current Level 2 Forklift Truck Operations National Occupational Standards and the Provision and Use of Work Equipment Regulations (PUWER) 1998 requirement for adequate training.

Assessor

Name (print)

Signature

Date:

Employer Authorisation

Name (print)

Signature

Date:

Refresher Due Date:

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Unit Achievement Certificate

Telehandler & Plant Operations

Candidate Name:

Company / Employer:

Date of Assessment:

Certificate Number:

Units Achieved

TH01 Prepare the Telehandler for Driving or Manoeuvring

TH02 Operate, Move or Manoeuvre the Telehandler

TH03 Select, Transfer and Position Loads Using a Telehandler

TH04 Undertake Post-operational Checks on Telehandler

TH05 Load Containers, Vehicles, Vessels or Platforms

TH06 Unload Containers, Vehicles, Vessels or Platforms

TH07 Load/Offload Telehandler onto Road Freight Vehicles

G01 Health, Safety and Security at Work

Machine Type

Telescopic Handler

360 Excavator

180 Excavator

Dumper

This certification is aligned to current Level 2 Plant Operations National Occupational Standards and the Provision and Use of Work Equipment Regulations (PUWER) 1998 requirement for adequate training.

Assessor

Name (print)

Signature

Date:

Employer Authorisation

Name (print)

Signature

Date:

Refresher Due Date:

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Practical Assessment Record

Counterbalance Forklift Truck — Practical Assessment

Candidate:

Company:

Date:

Truck Type / ID:

Location:

#	Assessment Item	C	ND	NYC
A. Pre-Use Inspection
1	Approaches truck safely, checks surroundings
2	Checks tyres and wheels for damage / pressure
3	Checks forks for damage, heel wear, cracks
4	Checks mast, chains and hydraulics
5	Checks fluid levels (oil, coolant, fuel / charge)
6	Checks brakes (foot and hand)
7	Checks steering operation
8	Checks warning devices (horn, lights, beacon)
9	Checks seat belt and operator restraint
10	Completes pre-use checklist correctly
B. Manoeuvring
11	Starts engine / motor correctly and safely
12	Moves off smoothly in correct gear / direction
13	Steers accurately through aisles and confined spaces
14	Reverses safely with all-round observation
15	Performs tight turns without striking obstacles
16	Controls speed appropriately for conditions
17	Uses horn at junctions and blind spots
18	Stops smoothly and applies brakes correctly
C. Load Handling
19	Assesses load before lifting (weight, condition, stability)
20	Approaches load squarely with forks at correct height
21	Inserts forks fully and evenly under load
22	Tilts mast back before lifting
23	Lifts load smoothly to safe travel height
24	Travels with load low and mast slightly back
25	Stacks loads safely at correct height
26	De-stacks loads safely with correct observation
27	Places loads accurately in designated area
28	Maintains safe clearances from racking / structures
D. Post-Operational
29	Parks in designated safe area
30	Lowers forks fully to ground
31	Applies parking brake and selects neutral
32	Switches off engine / motor and removes key
33	Reports any defects or issues

C = Competent | ND = Needs Development | NYC = Not Yet Competent

COMPETENT

NOT YET COMPETENT

Comments / Development Needs

Assessor

Name (print)

Signature

Date:

Candidate

Signature

Date:

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Practical Assessment Record

Teletruk / Telehandler — Practical Assessment

Candidate:

Company:

Date:

Machine Type / ID:

Location:

#	Assessment Item	C	ND	NYC
A. Pre-Use Inspection
1	Approaches machine safely, checks surroundings
2	Checks tyres and wheels for damage / pressure
3	Checks forks / attachment for damage and security
4	Checks boom, rams and hydraulic hoses
5	Checks fluid levels (oil, coolant, fuel / charge)
6	Checks brakes (service and parking)
7	Checks steering operation
8	Checks warning devices (horn, lights, beacon)
9	Checks seat belt and ROPS / FOPS cab
10	Completes pre-use checklist correctly
B. Manoeuvring
11	Starts engine correctly and safely
12	Moves off smoothly in correct gear / direction
13	Steers accurately through work areas and confined spaces
14	Reverses safely with all-round observation
15	Controls speed appropriately for conditions / terrain
16	Uses horn at junctions and blind spots
17	Stops smoothly and applies brakes correctly
C. Boom / Reach Operation
18	References load chart before lifting
19	Extends boom smoothly and under control
20	Retracts boom fully before travelling
21	Controls boom height accurately
22	Travels with boom low and retracted
23	Demonstrates awareness of stability during boom operation
D. Load Handling & Reach Work
24	Assesses load before lifting (weight, condition, stability)
25	Approaches load squarely with attachment at correct height
26	Picks up load safely using boom and tilt
27	Places loads at distance / height accurately (reach work)
28	Loads / unloads vehicles safely
29	Responds correctly to banksman signals
30	Maintains safe clearances from structures and personnel
E. Post-Operational
31	Parks in designated safe area on level ground
32	Lowers attachment fully, boom retracted
33	Applies parking brake and selects neutral
34	Switches off engine and removes key
35	Reports any defects or issues

C = Competent | ND = Needs Development | NYC = Not Yet Competent

COMPETENT

NOT YET COMPETENT

Comments / Development Needs

Assessor

Name (print)

Signature

Date:

Candidate

Signature

Date:

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Theory Test Answer Sheet

Candidate Name:

Date:

Company:

Section A — Counterbalance Forklift (25 Questions)

Write the letter of the correct answer or a short answer in each box. Pass mark: 80% (20/25)

Q10

Q11

Q12

Q13

Q14

Q15

Q16

Q17

Q18

Q19

Q20

Q21

Q22

Q23

Q24

Q25

Score:

/ 25

Pass Mark: 80% (20/25)

Result:

PASS

REFER

Section B — Teletruk / Telehandler (20 Questions)

Write the letter of the correct answer or a short answer in each box. Pass mark: 80% (16/20)

Q10

Q11

Q12

Q13

Q14

Q15

Q16

Q17

Q18

Q19

Q20

Score:

/ 20

Pass Mark: 80% (16/20)

Result:

PASS

REFER

Assessor

Name (print)

Signature

Date:

Candidate

Signature

Date:

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Employer Authorisation to Operate

Company Details

Company Name:

Address:

Contact Name:

Phone / Email:

Operator Details

Operator Name:

Date of Birth:

Employee Number:

Machine Categories Authorised

Counterbalance FLT

Teletruk / Telescopic FLT

Telescopic Handler

360 Excavator

180 Excavator / Backhoe Loader

Dumper

Specific Machines / Fleet Numbers

Machine Type	Make / Model	Fleet No.	Registration	Location / Site

Conditions / Restrictions

Training Evidence Ref / Certificate No.:

This authorisation confirms that the named operator has received adequate training and has been assessed as competent to operate the above equipment in accordance with the Provision and Use of Work Equipment Regulations (PUWER) 1998. This authorisation may be withdrawn at any time.

Authorised By (Employer)

Name (print)

Position:

Signature

Date:

Operator Acknowledgement

I confirm I have received adequate training and understand my responsibilities when operating the above equipment.

Signature

Date:

Review Date:

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Daily Pre-Use Inspection Checklist

Machine Type:

Fleet No.:

Registration:

Week Commencing:

Enter ✓ if OK or ✗ if defect found. Do NOT operate if serious defects are found — report immediately to your supervisor.

Inspection Item	Mon	Tue	Wed	Thu	Fri	Sat	Sun
Tyres / wheels
Forks / attachment
Mast / boom
Chains / hydraulics
Brakes (service & parking)
Steering
Lights / horn / beacon
Mirrors
Seat belt / restraint
Fluid levels
Bodywork / guards
Overall condition

Defect Details

Day	Defect Description	Reported To	Action Taken

Operator Signatures

	Mon	Tue	Wed	Thu	Fri	Sat	Sun
Operator Name
Signature

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Course Attendance Record

Course:

Date:

Location:

Trainer / Assessor:

No.	Delegate Name	Company	Signature In	Signature Out	Theory Result	Practical Result	Certificate No.
1
2
3
4
5
6
7
8

Course Notes / Observations

Trainer / Assessor

Name (print)

Signature

Date:

Site Contact / Employer Representative

Name (print)

Signature

Date: